Provider Demographics
NPI:1033506779
Name:SCOCCO, CHRISTOPHER MICHAEL (BS, MS, BCE)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:SCOCCO
Suffix:
Gender:M
Credentials:BS, MS, BCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7670 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2100
Mailing Address - Country:US
Mailing Address - Phone:561-242-1542
Mailing Address - Fax:561-684-0519
Practice Address - Street 1:7670 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2100
Practice Address - Country:US
Practice Address - Phone:561-242-1542
Practice Address - Fax:561-684-0519
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJB 614171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor